Sofosbuvir: a novel oral agent for chronic hepatitis C.

Area of Science:

• Hepatology and Viral Hepatitis Research
• Pharmacology and Drug Development
• Clinical Infectious Diseases

Background:

• Chronic hepatitis C (CHC) management has significantly evolved with the advent of direct-acting antiviral agents (DAAs).
• Hepatitis C virus (HCV) infection remains a global health concern, necessitating improved therapeutic strategies.
• Previous CHC treatments often involved interferon, associated with significant side effects and lower response rates.

Approach:

• This review focuses on sofosbuvir, a novel nucleotide analog and HCV NS5B polymerase inhibitor.
• It examines the efficacy and safety of sofosbuvir-based treatment regimens for CHC.
• The analysis includes data on sofosbuvir in combination with ribavirin and/or pegylated interferon.

Key Points:

• Sofosbuvir demonstrates potent antiviral activity, a high genetic barrier to resistance, and favorable pharmacokinetics.
• It exhibits excellent tolerability with limited drug interaction potential across all HCV genotypes.
• Sofosbuvir-containing regimens achieve high sustained virological response (SVR) rates in 12-24 weeks, including in difficult-to-treat populations.

Conclusions:

• Sofosbuvir represents a pivotal advancement in CHC therapy, marking a new era in its management.
• Interferon-free regimens incorporating sofosbuvir are emerging as the future standard of care.
• Sofosbuvir is ideally positioned as a cornerstone agent, particularly in combination with other DAAs for challenging CHC cases.